Prevalence and risk factors for high-risk human papillomavirus infection among women from three southern geopolitical zones of Nigeria
Chika Onwuamah, Ning Feng, Abidemi Esther Momoh, Mabel Uwandu, Rahaman A. Ahmed, Ifeoma Idigbe, Grace Deborah Vincent, Angela Chinenye Ogbu, N.S. Okonkwo, Judith Sokei, Bowofoluwa Sharon Abimbola, Temiloluwa Ojopagogo, Leona Chika Okoli, Mary Adesina, Priscilla Ezemelue, Omowunmi Sowunmi, Jane Okwuzu, Olaoniye Habeebat Labo−Popoola, Joseph Ojonugwa Shaibu, Greg Ohihoin, Emily Nzeribe, Agatha David, O.D. Olaleye, Ighovwerha Ofotokun, Xiao‐Ping Dong, Oliver Ezechi
Abstract
Introduction: Human Papillomavirus (HPV) infection is a risk factor for cervical cancer, the fourth most common cancer among women globally. Its burden is the highest in sub-Saharan Africa, with over 90% mortality. Interventions may fail without evidence-based data on stratified prevalence and risk factors among most at-risk women across Nigeria. Methods: A cross-sectional comparative study, with participants recruited from the Nigerian Institute of Medical Research's Clinics, NGO outreaches, a cancer screening centre and a university teaching hospital. Questionnaires were self-administered. Trained medics performed sampling at healthcare facilities, and self-sampling was used at outreaches. Results: Nine hundred eighty-five study participants were recruited. About 37% and 27% of the women knew about HPV and its vaccines, respectively, but only 6% confirmed vaccination with HPV vaccines. HPV prevalence was highest among women with unknown marital status (35.9%), single women (33.8%), widowed/divorced/separated women (30.3%), and married/cohabiting women (19.6%). HPV infection was significantly higher among women who take alcohol (odds=1.7 [95% CI: 1.2-2.4]) and women who smoke (odds=2.6 [95% CI: 1.4 - 4.6]. HPV strains detected included HPV16 (1.3%), HPV18 (1.5%), Low Risk (0.2%) and Other High-Risk groups (19.7%). Conclusion: The inverse relationship between prevalence and education suggests interventions improving awareness and prevention would be impactful. Such interventions could also target HIV-positive women, women presenting with sexually-transmitted infections, who smoke and frequently drink alcohol.